Lunch with 4th years

Today, almost 40 first and second years had lunch with 4 fourth years who matched in primary care residency programs to discuss clerkship and residency questions before they graduate in just a few weeks. If you were unable to attend, here's a summary of our discussion with Caitlin, Derek, John, and Robin, all of whom were candid in sharing their memories, experiences, and advice.

How did you decide to go into primary care; when did you make that decision?
With experiences before coming to BUSM like being in the Peace Corps and volunteering in urban shelters, most of the students knew from the beginning that they wanted to be in primary care. The family medicine clerkship at BU was also a great experience. One of the 4th years initially wanted to do surgery, until he finished the surgery clerkship and realized that it was not for him-- all that getting-up-early and standing-all-day business. He's now going into pediatrics with an interest in neonatology.

International away rotations: how many, and which clerkships can count?
In 4th year, you can do up to 3 away electives. Loophole: there are "inside away" electives, which are programs that are not here at BU, but that are credited and count as though you did it here. So, you could potentially do up to 4 months away, plus an additional 2 months of vacation/interview time... you could be away from Boston for 6 months! You can do away rotations for any of the clerkships if you find the right programs. One of the 4th years did the ER clerkship in Chile and the Family Medicine clerkship in Lesotho!

Did ICM affect your decision for residency?
Short answer: no. Longer discussion: the students shared that in such a big hospital setting, you will run into residents and attendings in the various clerkships who may look down on primary care. That can be discouraging, but it also brought the students who were interested in primary care closer together with shared experiences.

What do you wish you had known before starting third year; general advice?
In all your clerkships, keep an open mind. You may be surprised by what you enjoy, what you are good at, and what you do not like. In your clerkships, push push push for what you want to do and learn. As the youngest member in a large team setting, it is easier to stay in the background, but if you are proactive in your education, you will have many more opportunities to do and to learn. Arrive 5 minutes early and quickly review the patients who were admitted overnight to be more prepared when you round on the patients! When things are difficult, remember that each clerkship is temporary and short, and you WILL get through it. Don't take mean comments personally if it happens. Know that you are getting excellent clinical training at BU.

Which third year clerkships are better to do at BMC instead of the other sites?
Medicine, surgery, and pediatrics were highly recommended to do at BMC. And the fourth years all advised that the order of your clerkships in 3rd year does not really matter-- except that doing medicine before surgery will be really helpful. One tip was that new residents start in June/July, so you may have less chances to do procedures compared to the end of the year in April/May. Another tip: your sub-internship grades are important, and there are many sub-i choices.

Favorite part of your clinical years in med school?
Sub-I. By that point, you do feel like you know what you are doing, and it's fun. Doing a rotation at an Indian Health Service, a completely different experience. Going abroad for electives.

Lastly, remember to eat something before going into the OR lest you pass out!